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dc.contributor.authorVirk, Amrit
dc.contributor.authorKing, Rebecca
dc.contributor.authorHeneise, Michael Timothy
dc.contributor.authorAier, Lanuakum
dc.contributor.authorChild, Catriona
dc.contributor.authorBrown, Julia
dc.contributor.authorEnsor, Tim
dc.date.accessioned2024-10-04T10:48:06Z
dc.date.available2024-10-04T10:48:06Z
dc.date.issued2024-06-26
dc.description.abstractBackground Surgical services are scarce with persisting inequalities in access across populations and regions globally. As the world’s most populous county, India’s surgical need is high and delivery rates estimated to be sub-par to meet need. There is a dearth of evidence, particularly sub-regional data, on surgical provisioning which is needed to aid planning.<p> <p>Aim and method This mixed-methods study examines the state of surgical care in Northeast India, specifically health care system capacity and barriers to surgical delivery. It involved a facilitybased census and semi-structured interviews with surgeons and patients across four states in the region. <p>Results Abdominal conditions constituted a large portion of the overall surgeries across public and private facilities in the region. Workloads varied among surgical providers across facilities. Task-shifting occurred, involving non-specialist nursing staff assisting doctors with surgical procedures or surgeons taking on anaesthetic tasks. Structural factors dis-incentivised facility-level investment in suitable infrastructure. Facility functionality was on average higher in private providers compared to public providers and private facilities offer a wider range of surgical procedures. Facilities in general had adequate laboratory testing capability, infrastructure and equipment. Public facilities often do not have surgeon available around the clock while both public and private facilities frequently lack adequate blood banking. Patients’ care pathways were shaped by facility-level shortages as well as personal preferences influenced by cost and distance to facilities. <p>Discussion and conclusion Skewed workloads across facilities and regions indicate uneven surgical delivery, with potentially variable care quality and provider efficiency. The need for a more system-wide and inter-linked approach to referral coordination and human resource management is evident in the results. Existing task-shifting practices, along with incapacities induced by structural factors, signal the directions for possible policy action.en_US
dc.identifier.citationVirk, King, Heneise, Aier, Child, Brown, Jayne, Ensor. How ready is the health care system in Northeast India for surgical delivery? A mixed-methods study on surgical capacity and need. PLOS ONE. 2024;19(6)en_US
dc.identifier.cristinIDFRIDAID 2284389
dc.identifier.doi10.1371/journal.pone.0287941
dc.identifier.issn1932-6203
dc.identifier.urihttps://hdl.handle.net/10037/35054
dc.language.isoengen_US
dc.publisherPLOSen_US
dc.relation.journalPLOS ONE
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2024 The Author(s)en_US
dc.rights.urihttps://creativecommons.org/licenses/by/4.0en_US
dc.rightsAttribution 4.0 International (CC BY 4.0)en_US
dc.titleHow ready is the health care system in Northeast India for surgical delivery? A mixed-methods study on surgical capacity and needen_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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Attribution 4.0 International (CC BY 4.0)
Med mindre det står noe annet, er denne innførselens lisens beskrevet som Attribution 4.0 International (CC BY 4.0)